The impact of immunonutrition in head and neck cancer surgery: a systematic review with meta-analysis.

Davide Mattavelli, Cesare Piazza, Lorenzo Tofani, Claudia Lodovica Modesti, Gabriele Testa

Journal: Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 2025;45(2):75-83

PMID: 40353479

Abstract

OBJECTIVE

Malnutrition is common among patients undergoing surgery for head and neck cancer (HNC), leading to higher postoperative complications and mortality rates. Immunonutritional intervention has potential in reducing these risks by enhancing immune function and aiding wound healing.

METHODS

A systematic review and meta-analysis were conducted according to PRISMA guidelines. Nineteen randomised controlled trials involving 1,196 participants undergoing surgery for HNC were included. Studies comparing immunonutrition with standard care were analysed for outcomes including fistula formation, wound infections, other infections, and length of hospital stay.

RESULTS

Immunonutrition significantly reduced postoperative fistulas and shortened hospital stays compared to standard care. The impact on wound and systemic infections was inconclusive. Immunonutrition was generally well-tolerated, with no significant increase in adverse events.

CONCLUSIONS

These findings highlight the potential benefits of immunonutrition in improving postoperative outcomes for patients with HNC. However, the variability in study outcomes and limitations in quality call for further research to clarify the specific efficacy, long-term effects, and cost-effectiveness of immunonutrition in this context.

Copyright © 2025 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.

Address: Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy.; Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy.; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.; Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy.
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